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General NPI Number Information
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NPI Number | 1013443902
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Entity Type | Organization
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Legal Business Name | COHEN CHIROPRACTIC INC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 8781 CUYAMACA ST SUITE J
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City | SANTEE
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State | CA
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Zip | 92071-4216
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Country | US
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Telephone | 619-449-0593
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Fax |
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Provider Business Mailing Address
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Address Line | 8781 CUYAMACA ST SUITE J
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City | SANTEE
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State | CA
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Zip | 92071-4216
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Country | US
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Telephone | 619-449-0593
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LANCE H COHEN
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Credential | DC
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Telephone | 619-449-0593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 31652
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License Number State | CA
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